Nashville health survey: A third of Latinos are uninsured, most don’t have a doctor

Brett Kelman, Nashville Tennessean

Latinos who live in Nashville are more than four times as likely to not have health insurance than their white or black neighbors, revealing vulnerability for one of the city’s largest minorities, according to a landmark survey by city officials and the nonprofit NashvilleHealth.

Survey data shows that one third of Latinos don’t have insurance and more than half do not have a personal doctor or health care provider. Only 46 percent have visited a doctor for a routine checkup in the past year.

Doctor visits and health insurance are simply out of reach for many Latino families, who struggle with poverty, transportation and language barriers, according to officials from two local Latino organizations. The access to health care is even worse for immigrants who entered the country illegally and therefore do not qualify for TennCare. However, challenges persist exist for legal immigrants also.

“For a certain segment of the American population, who are citizens and have access to all the rights and benefits that you can have in American society, it is just something they cannot afford,” said Yuri Cunza, president of the Nashville Area Hispanic Chamber of Commerce.

These statistics on Latino health were revealed last week in the first-ever Nashville Community Health + Well-being Survey, which was conducted through a partnership between the city and a nonprofit and collected the largest and most detailed health data in nearly two decades. The survey covers traditional health topics like obesity and high blood pressure, but also includes less-studied health issues like vaping, firearm ownership and even racial discrimination.

Nashville residents who are Latino or gay, lesbian or bi-sexual are dramatically less likely to have health insurance, according to a landmark heath survey. (Photo: Nashville Community Health + Well-being Survey analysis)

Former U.S. Sen. Bill Frist, who founded NashvilleHealth in 2015, said the survey was intended to set a “baseline” from which the city can identify its most vulnerable residents and ultimately improve all public health. Nashville may be a national leader in health care, but the city is surprisingly unaware of it’s own health problems, Frist said.

“We, as a city, are much worse off than people think,” Frist said, “and we can’t sustain Nashville the way we are going. … We have good health care here, but the health and well-being is miserable.”

Many most dramatic findings related to access to health care. In addition to the worrisome stats on Latino health, the survey revealed residents who are gay, lesbian or bi-sexual were nearly four times as likely to be uninsured than their straight peers.

Citywide, 90 percent of residents had health insurance. Only 70 percent of gay, lesbian and bisexual populations had coverage. Only 67 percent of Latinos did.

Andrés Martínez, a spokesman for Conexión Américas, a nonprofit that supports Latinos in Nashville, said language barriers were at the heart of many of the Latino health issues in the city. 

Doctors who speak Spanish are few and far between, Martínez said, and some Latino families may not have the driver’s licenses or reliable vehicles needed to travel across the city for a check-up with a Spanish-speaking doctor.

“It is difficult to navigate the health care system even if you speak the language,” he said. “But if you don’t speak the language, or you aren’t from this country, how do you even start?”

The survey gathered data from 1,805 respondents, spread proportionately throughout Davidson County. Participants were paid $11 to complete a detailed questionnaire. The head researcher on the project, Dr. Timothy Johnson from the University of Illinois at Chicago Survey Research Laboratory, said the survey results offered “critical insights to enact positive change” in the health of the city.

Johnson added that the survey results will be especially useful because they are entirely public. Often, city governments keep surveys like this one largely confidential, he said, but the full survey analysis is published online, and the entire data is available to researchers on request. 

“There are tons of really smart people in this city, from graduate students to senior faculty, to dig their teeth into this,” Johnson said. “Give it to them, turn them loose and we will all benefit.”

READ THE RESULTS: Want to see the survey results? Get the whole report here.

Previously, Nashville health info has come from two sources, and neither were great. The Centers of Disease Control and Prevention release some annual health data about the city, but the data comes from only 250 phone surveys. Metro Public Health Department conducted a more thorough survey in 2000, but Nashville has grown dramatically since then.

“Data guides every decision that we make,” said Dr. Sanmi Areola, Nashville’s deputy health director. “And for a city like Nashville that has changed so much, what we knew 10 years ago would not necessarily hold true. Now this just allows us to understand our city.”